A Survey on The Current Status of High-School Students’ Sense of Self-Esteem

Paper : Adolescent Health

A Survey on the Current Status of High-SchoolStudents’ Sense of Self-Esteem― Correlations between High-School Students’ Sense
of Self-Esteem and Satisfaction with School Life ―Michiyo Okada*, Takeshi Suzue*, Hiroko Tamura*, Ai Fujikawa*,
Yumiko Ichihara*, Harunobu Shima*, Shigeru Suna* and Fumihiko Jitsunari**

Department of Hygiene/Public Health Faculty of Medicine University of Kagawa
1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793 Japanmichell_kaiaya@yahoo.co.jp[Received October 12, 2007 ; Accepted January 15, 2009]

In this study, a questionnaire survey was conducted using a "sense of self-esteem" scale toclarify the "sense of self-esteem" of Japanese high-school students. Additionally, correlations
between their sense of self-esteem and satisfaction with school life were analyzed, because
the latter depends greatly on relationships between friends, their sense of self-esteem, andgrade/gender differences. Valid responses to the questionnaire were collected from 2,112
students (862 boys and 1,250 girls) of all grades at three public high schools in Japan.
Six factors ("introverted personality and human distrust," "pleasure and a feeling of
fulfi llment," "self-manifestation and motivated personality," "strain from peer criticism,""self-acceptance," and "self-realization") were extracted from a factor analysis of the "senseof self-esteem" scale. For the characteristics of these students, a comparison was performedby grade, revealing that their sense of self-esteem generally decreased with increasing grade.
Another comparison, by gender, demonstrated that boys accepted the current self, andwere satisfied with themselves, while girls were not, and that boys felt themselves as yet tobegin self-realization, while girls saw themselves generally on their way to it. A significant
correlation was identified between the "sense of self-esteem" and "level of satisfaction withhigh-school life" scales. It was clarified that students who were more open-minded, felt more
pleasure, and more actively accepted themselves felt a greater sense of having friends, andwere more satisfied with their school lives, whereas those more introverted and more anxious
about the opinions of others felt less of a sense of having friends, less fulfi llment in school
activities, and were not as satisfied with their school lives.
Keywords: high-school student, sense of self-esteem, satisfaction with school life, self-acceptance,
self-realization[School Health Vol.5, 1-8, 2009]

1. Introduction
It has been pointed out that a sense of self-esteem
in young people is closely related to their smoking,drinking, and drug-abusing behaviors (Kawabata,et al., 1999, 2005), which are closely associatedwith their family relationships as well as friendships(Ogawa, et al., 2006), and that the same is true of
their sexual behavior and life skills (Kawabata,et al., 2007). Therefore, relationships with
School Health Vol.5, 1-8, 2009http://www.shobix.co.jp/sh/hpe/main.htm

others, including family members and friends, areimportant to every adolescent. They are essential
in developing one's identity. The importance ofthe surrounding environment is evident because
one's existence can be valued by relationships withothers (Nagata, et al., 2005), and because, as aninternal factor for developing the self, self-value
does not simply depend on the degree of self-esteem,
but follows external standards (Ito and Kodama,2005). Furthermore, it has been demonstrated
1

Okada, M., et al.

that the presence of friends positively affects
self-development during adolescence; the more
one had experiences with friends in his/her earlyadolescence, the more he/she desires to enter school(Tanaka, et al., 2005). In view of these studies,
high-school students more satisfied with their school
environments, where they spend much time with
their friends, are expected to have a stronger senseof self-esteem and a greater level of satisfaction withthemselves. In contrast, those not satisfied with theirschool lives may lack a sense of self-esteem, become
unsatisfied with themselves, and consequently havetrouble organizing their social lives.
However, no research in high-school students has
been conducted to clarify the relationship between
their sense of self-esteem and satisfaction with school
life. Clarifi cation of this relationship may help
improve their school lives, and aid in the preventionof smoking, drinking, drug-abusing, and dangerous
sexual behaviors.
The present study was intended to clarify thecurrent status of high-school students’ school lives
and how they saw themselves, using a "sense of
self-esteem" scale (Hiraishi.,1993).
Additionally, correlations between a "level ofsatisfaction with high-school life" scale (Okada,
2005; Okada, et al., 2007), which determines whether
high-school students are satisfied with their school
lives, and a "sense of self-esteem" scale (Hiraishi.,1993) were explored to understand how high-school
students behaved, and saw not only themselves but
also their relationships with others in their school
lives within the context of these two scales.

2. Methods
2.1. Subjects
A questionnaire was sent to 2,646 students ofall grades at three full-time public high schools in
A Prefecture. Responses with neither missing nor
inappropriate answers were collected from 2,112
students (862 boys and 1,250 girls), including 669
first (280 boys and 389 girls), 722 second (278 boys
and 444 girls), and 721 third graders (304 boys and
417 girls), and then subjected to analysis (effective
response rate: 79.8%).

2

2.2. Survey contents
The "sense of self-esteem" scale was designed
to estimate high-school students’ sense of
self-esteem. It consisted of 41 items representing
the adolescence-specific disposition, which largely
formed two subscales covering the "self-conscious"and "others-conscious" areas. The self-conscious
area involved 4 items of "self-acceptance," 7 itemsof "self-realization," and 8 items of "pleasure and afeeling of fulfi llment," while the others-conscious
area included 8 items of "introverted personality andhuman distrust," 7 items of "self-manifestation andmotivated personality," and 7 items of "strain frompeer criticism."
To apply scales used in previous investigations
to this study, it was necessary to validate what eachscale was intended to measure, given that the subjectsof the present study were high-school students. Thus,
the characteristics of high-school students were
elucidated based on the structure and the mean ofsummed scores of each scale. The following 5-point
scoring system was used for each item of the scale:"Applicable (5 points)", "Somewhat applicable (4)","Undetermined (3)", "Generally not applicable (2)",and "Not applicable (1)". For reverse items, reverse
scoring (from 1 to 5 points) was performed.
The "level of satisfaction with high-schoollife" scale (Okada, et al., 2007) is designed to ask
individual high-school students whether they aresatisfi ed with their overall school lives, including
school events, and how they feel about such lives.
The students are expected to select one of the fi ve
possible answers (1) Agree, 2) Partially agree, 3)
Undetermined, 4) Partially disagree, and 5) Disagree)
to each of the 20 questions in total, including two
items about participation in school activities, one
item about frictions at school, two items aboutfamiliarity with friends, one item about a sense ofsatisfaction with school, two items about orderly
behavior, one item about academic/intellectual
development, four items about the school
environment, four items about social relationships,
and three items about an overall sense of fulfillment.
It consists of four factors, "satisfaction with school
life," "presence of friends," "attachment to school,"and "a feeling of fulfillment in school activities."

School Health Vol.5, 1-8, 2009http://www.shobix.co.jp/sh/hp/main.htm

A Survey on The Current Status of High-School Students’ Sense of Self-Esteem

2.3. Survey period and methods
The survey was conducted in late April 2003,
with all subjects simultaneously completing thequestionnaire on an anonymous basis in theirclassrooms. Regarding ethical considerations, thesubjects were orally explained to that they could
anonymously answer the questions, would not bedisadvantaged even if they did not answer them,and that the survey results would all be statisticallyprocessed and only used for the purpose of this study.
Their consent was assumed upon the submission of
their answers.

2.4. Statistical analysis
The survey results were processed using thestatistical package SPSS 10.0j for Windows to
perform factor analysis based on the principal
factor method using varimax rotation, and identify
factor structures. For the interpretation of factors,
40 items with a factor loading not less than 0.4 fora particular factor were selected. Although items
that load multiple factors are usually omitted fromthe interpretation of factors, this study did use suchitems with the smaller loads listed in parentheses
in the table. To score the results of each factor, thesum of scale scores for items concerned with thefactor (sum of scale scores hereafter) was used.
The reliability of each factor was evaluated by
calculating the reliability coeffi cient (Cronbach’sα). To understand the current status of high-school
students’ sense of self-esteem, variance analysis ofsum scale scores on the "sense of self-esteem" scale
was performed with respect to grade (three levels:
fi rst to third grades) and gender (two levels: maleand female), and Bonferroni’s method was used for
multiple comparison. The significance level was set
to 5% in all cases. In consideration of the presenceof gender/grade differences in the index data, partial
correlation coefficients were calculated to evaluate
the significance of correlations between the scales.
For partial correlation coefficients, gender and school
year were controlled.

3. Results
3.1. Factor analysis and naming
Table 1 shows the factor structures of the "sense
School Health Vol.5, 1-8, 2009http://www.shobix.co.jp/sh/hpe/main.htm

of self-esteem" scale. There were 9 items markedly
loading on the fi rst factor (F1), including "I feel a
psychological barrier separating me from others,""I feel human relations are troublesome," "I am notfriendly to others," "I have shut my heart to others,""If I am talking with a friend, I feel anxious," "Ifeel sad somehow even when I am with a friend,""I feel alone," "I don’t trust others," and "I never
have a pleasant day (an item to be scored inversely,
hereinafter marked with an asterisk)." Since these
items refl ected personal feelings regarding others,
F1 was termed "introverted personality and human
distrust."
There were also 9 items strongly loading on thesecond factor (F2), including "I have a feeling ofcontent," "I feel my life is very pleasant," "I don’t havevexations and feel good," "I feel mentally at ease,""I can do my favorite things," "I feel alive and free,""I never feel satisfied*," "I feel I can do anything,"and "I never have a pleasant day*." Since these items
represented a feeling of fulfi llment in life, F2 wastermed "pleasure and a feeling of fulfillment."
There were 7 items markedly loading on the third
factor (F3), including "If I have a question, I ask
it without hesitation," "I say what I feel freely inpublic," "I talk with partners until I am convinced,""I talk with friends earnestly," "I say what I wantto say, minding the feelings of others," "I can goout in public," and "I voluntarily talk to friends."
Because these items meant manifesting the self
to others as well as motivation, F3 was termed"self-manifestation and motivated personality."
There were also 7 items markedly loading on the
fourth factor (F4), including "I am afraid that myimage will be harmed," "I mind public attention," "Iam unable to move, if conscious of public attention,""I care about whether I am superior or inferior toothers," "I am too anxious about people, and am
tired," "I strain myself to deal with people," and "Ialways try to impress others favorably." Since these
items suggested consideration of others’ criticism andmental strain resulting from it, F4 was termed "strain
from peer criticism."
There were 5 items strongly loading on the fi fth
factor (F5), including "I accept my individuality," "Idevelop my strengths," "I value my individuality,""I accept my good and bad points," and "I havemy own life." Because these items were related
to the acceptance of self, F5 was referred to as"self-acceptance."3

Okada, M., et al.

Table 1 Factor-loading of the “Sence of Self-esteem” Scale(n=2,112)Items
��
17 I feel a psychological barrier separating me from others.
.671
18 I feel human relations are troublesome.
.666
24 I am not friendly to others.
.657
19 I have shut my heart to others.
.653
23 If I am talking with a friend, I feel anxious.
.637
22 I feel sad somehow even when I am with a friend.
.580
25 I feel alone.
.572
14 I dont trust others.
.571
13 I have a feeling of content.
-.182
11 I feel my life is very pleasant.
-.242
12 I dont have vexations and feel good.
-.181
21 I feel mentally at ease.
-.121
20 I can do my favorite things.
-.094
16 I feel alive freely.
-.113
39 I never feel satisfied. �-.359
8 I feel I can do anything.
-.150
40 I never have a pleasant day. �(-.454)27 If I have a question, I ask it without hesitation.
.033
29 I say what I feel freely in public.
.002
26 I talk with partners until I am convinced.
-.055
28 I talk with friends earnestly.
-.165
30 I say what I want to say, minding the feeling of others.
-.128
35 I can go out in public.
-.196
31 I voluntarily talk to friends.
-.317
33 I am afraid that my image will be harmed.
.037
32 I mind attention.
.030
34 I am unable to move, if conscious of the public attention.
.240
37 I care about whether I am superior or inferior to others.
.176
38 I am too anxious about people, and am tired.
.295
36 I strain myself to deal with people.
.347
5 I always try to impress others favorably.
.020
4 I accept my individuality.
-.098
2 I develop my strengths.
-.149
1 I value my individuality.
-.093
3 I accept my good and bad points.
-.034
7 I have my own life.
-.145
15 I dont have an aim. �-.214
10 I am highly motivated to fulfill my dream.
.014
9 I dont know what I want to do. �-.077
6 I have passion and tackle challenges.
-.092
41 I will take a positive attitude toward the problem.
-.200
Sum of squares on the principal loading of factors
4.313
Percentage of contribution of factors��)
10.5
Percentage of cumulative contribution of factors��)10.5
� Indicates item scored inversely.
Shaded scores, such as, indicate factor loading not less than 0.4.

��
-.142
-.133
-.131
-.119
-.090
-.175
-.169
-.116

.724
.719
.717
.611
.545
.544
.527
.495
.461

.090
.140
.130
.129
.138
.234
.203
-.040
-.038
-.053
-.088
-.201
-.161
.053
.223
.225
.171
.213
.088
.077
.232
.121
.291
.346
4.128
10.1
20.6

There were 4 items markedly loading on the sixth
factor (F6), including "I don’t have an aim*," "I amhighly motivated to fulfill my dream," "I don’t knowwhat I want to do*," and "I have passion and tackle
challenges." Because these items are related to therealization of self, F6 was termed "self-realization."
Although a total of seven factors were extracted
from factor analysis, the seventh factor was not used
4

��
-.179
-.148
-.130
-.121
-.026
-.029
.027
-.050
.190
.182
.183
.086
.165
.210
.049
.191
.045

.720
.698
.588
.565
.530
.514
.457

-.067
-.066
-.112
.001
-.059
-.146
-.013
.217
.237
.301
.207
.140
.048
.162
.054
.146
.225
3.142
7.7
28.3

��
.138
.139
.054
.142
.103
.188
.217
.010
-.006
.023
-.101
-.089
-.054
-.109
-.237
.059
-.076
-.137
-.149
-.055
-.010
.054
-.187
.087

.824
.765
.637
.500
.498
.491
.469

-.139
.058
-.056
-.127
.036
-.044
.042
-.159
.086
.000
3.05
7.4
35.7

��
-.007
-.035
-.152
-.039
-.142
-.079
-.120
-.067
.149
.187
.123
.102
.184
.232
.039
.257
.104
.104
.133
.148
.156
.250
.190
.174
-.071
-.066
-.107
-.054
.019
-.031
.069

.659
.615
.585
.524
.404

.094
.234
.022
.305
.306
2.369
5.8
41.6

��
-.081
-.130
-.098
-.015
-.026
-.041
-.026
-.124
.212
.160
.040
.034
.262
.009
.233
.378
.175
.078
.060
.116
.105
.052
.017
.034
-.060
-.063
-.008
.005
.014
.013
-.020
.072
.276
.163
.033
.109

.723
.642
.605
.445

.325
2.194
5.4
46.9

F7
-.284
-.120
.164
-.159
.324
.174
.060
-.037
.044
-.028
.074
.048
-.106
-.082
-.187
.058
-.264
-.018
.055
-.019
-.105
-.073
.145
.133
-.134
-.181
-.004
.146
.211
.220
-.002
-.031
.080
-.031
.037
-.137
-.041
.060
.024
-.015
.035
.683
1.7
48.6

communality
.608
.535
.528
.503
.550
.442
.422
.363
.662
.671
.613
.417
.450
.425
.555
.520
.538
.564
.553
.404
.409
.390
.449
.408
.713
.633
.490
.313
.424
.458
.229
.567
.593
.502
.382
.244
.590
.553
.416
.413
.410

in the analysis because it had a sum of squares on
the principal loading of factors not greater than 1.0
and a percentage contribution of factors not greaterthan 5.0%, and showed no item consistent with thecriterion that a factor loading for interpretation must
be 0.4 or greater.

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A Survey on The Current Status of High-School Students’ Sense of Self-Esteem

Table 2 The result of ANOVAs of the “Sense of Self-Esteem”scale
Introverted personality
and human distrustnMean SD F value

1st graders 669 22.3

6.0

2nd graders 722 23.0

5.9 3.310 *3rd graders 721 23.1

5.9

Boys

862 23.0 5.9

Girls1,250 22.8 6.0

Pleasure and a feelingof fulfillment

� Mean SD

29.7 7.6

27.8 7.3
0.557l n.s.

28.4 7.1
28.7 7.5

�*** 28.4 7.0 11.371 ***0.030 n.s.

grade×gender

F value

Self-manifestationand motivated personality
Mean SD F value

22.1 5.5*** 22.0 5.2

21.8 5.1
22.2 5.50.753 n.s.

� Mean SD F value

� Mean SD F value

22.7 5.3

19.5 3.6

Self-realization
� Mean SD F value*

0.296. n.s. n.s. 23.0 5.2 1.251 n.s. n.s. 18.9 3.5 4.075 *22.7 5.3

22.0 5.4
0.845 n.s.

Self-acceptance

Strain from peer criticism

2.955 n.s.

22.8 5.2
22.8 5.3

0.174 n.s.

19.4 3.6
19.0 3.6

0.949 n.s.

13.1 3.9
12.6 3.5 4.275 *

19.2 3.6
0.012 n.s.

13.2 3.8
12.7 3.7

4.282 *

13.1 3.8

0.248 n.s.

† Bonferroni's multiple comparisons�*

5.001 *
3.947 *

* <.05 ***p**p<.01 ******p<.001

Table 3 Mean and standard deviation of each score of the “Sense of Self-Esteem” scale for graders and genderBoys
1st graders
Girls
Boys
2nd graders
Girls
Boys
3rd graders
Girls

n
280
389
278
444
304
417

Introverted personality
and human distrust
Mean
SD

22.5
22.2
23.1
23.0
23.3
23.0

6.0
6.1
6.0
5.9
5.9
6.0

Pleasure and a feelingSelf-manifestationof fulfillment
and motivated personality
Mean
SD
Mean
SD

29.3
29.9
28.6
28.3
27.4
28.0

7.6
7.6
6.9
7.0
6.8
7.6

3.2. Examination of reliability
The reliability of internal consistency (coefficientα) for each factor was as follows: coefficient α = 0.75
for F1 (introverted personality and human distrust),
0.89 for F2 (pleasure and a feeling of fulfi llment),
0.83 for F3 (self-manifestation and motivatedpersonality), 0.82 for F4 (strain from peer criticism),
0.78 for F5 (self-acceptance), and 0.75 for F6(self-realization).
These values are large enough to ensure thereliability of the "sense of self-esteem" scale, which
consists of the six factors F1 to F6.

3.3. The current status of high-school students’sense of self-esteem
Tables 2 and 3 show the results. In comparison bygrade, a major effect of each grade was identified at
the 5% level for the factors "introverted personality
and human distrust," "pleasure and a feeling of
fulfillment," "self-acceptance," and "self-realization."N o s i g n i fi c a n t d i ff e r e n c e w a s o b s e r v e d f o r"self-manifestation and motivated personality"and "strain from peer criticism." According to
Bonferroni’s multiple comparison, the mean of thesum scale scores for "introverted personality and
School Health Vol.5, 1-8, 2009http://www.shobix.co.jp/sh/hpe/main.htm

22.0
22.2
21.7
22.1
21.7
22.2

5.1
5.7
4.8
5.4
5.3
5.5

Strain from peer
criticism
Mean
SD

Mean

SD

Mean

SD

22.5
22.9
23.3
22.9
22.6
22.8

19.7
19.3
19.2
18.7
19.3
19.1

3.6
3.6
3.4
3.6
3.9
3.5

13.2
13.0
12.4
12.7
12.6
13.6

4.0
3.8
3.4
3.7
3.8
3.9

5.3
5.4
4.9
5.4
5.4
5.2

Self-acceptanceSelf-realization

human distrust" was significantly higher in third thanin first graders, and showed no significant differences
between fi rst and second graders and between
second and third graders. The mean of the sum scalescores for "pleasure and a feeling of fulfi llment"
was signifi cantly higher in fi rst than in second andthird graders, and showed no significant differences
between second and third graders. The mean of
the sum scale scores for "self-acceptance" wassignifi cantly higher in fi rst than in second graders,
and revealed no significant differences between first
and third and between second and third graders. The
mean of the sum scale scores for "self-realization"
was signifi cantly higher in third than in second
graders, and showed no signifi cant differences
between first and second and between first and third
graders.
In a separate comparison by gender, a major
effect of gender was observed at the 5% level forthe factors "self-acceptance" and "self-realization."
No significant difference was found for "introverted
personality and human distrust," "pleasure anda feeling of fulfi llment," "self-manifestation andmotivated personality," and "strain from peer
criticism." The mean of the sum scale scores for"self-acceptance" was signifi cantly higher in boys
than in girls, whereas that for "self-realization" was5Okada, M., et al.

Table 4 Partial Correlation coeffi cients between the"Level of Satisfuction with High School Life” and the"Sense of
Self-Esteem”scales(n=2,112)

Satisfaction
with school life

Presence of friends

Attachment
to school

A feeling of
fulfillment inschool activities

Introverted
personality andhuman distrust

Pleasure anda feeling of
fulfillment

Self-manifestationand motivatedpersonality

Strain frompeer criticism

Self-acceptanceSelfrealization

Satisfaction with school life
Presence of friends.589 **

Attachment to school.824 **.477 ****.646 **.453 **-.408 **-.426 **-.283 **-.472 **

.690 **.505 **.533 **.509 **-.401 **

**

**

**

**

-.312 **

.467 **

A feeling of fulfillment
in school activities
Introverted personality
and human distrust
Pleasure and a feelingof fulfillment
Self-manifestationand motivated personality

.681

.379

.445

.264

.490

Strain from peer criticism-.124 **-.093 **-.067 *-.173 **

.387 **-.282 **-.227 **

Self-acceptance.419 **.419 **.336 **.448 **-.283 **

.516 **.532 **-.193 **

Self-realization

**

**

**

**

**

**

**

-.129 **

.327

.310

.289

.272

-.236

.487

.308

.427 *** <.01 ***p**p<.001

significantly higher in girls than in boys.
Interactions between grade and gender onlys h o w e d a s i g n i fi c a n t d i ff e r e n c e i n t e r m s o f"self-realization." That is, the mean of the sum scalescores for "self-realization" was significantly higher
in third-grade girls than in second-grade boys ((p<.001), second-grade girls ((p <.05), and third-grade
boys ((p <.05).

3. 4 . Cor relat ions bet we en the "level ofsatisfaction with high-school life" and the"sense of self-esteem" scales
High-school students’ levels of satisfaction with
their school lives may differ depending on theirsense of self-esteem. Thus, partial correlation
coeffi cients adjusted for grade/gender differenceswere calculated to examine correlations between
four factors extracted from a factor analysis of the"level of satisfaction with high-school life" scale
and the six subscales of the "sense of self-esteem"
scale (Table 4). The resulting coefficients indicatedsignifi cant correlations between both scales.
More specifi cally, "satisfaction with school life,""presence of friends," "attachment to school," and"a feeling of fulfi llment in school activities" werepositively correlated with "pleasure and a feeling of
fulfillment," "self-acceptance," and "self-realization,"and negatively correlated with "introverted
personality and human distrust" and "strain from peer
criticism."

6

4. Discussion
This study on the current status of high-school
students’ sense of self-esteem revealed that this sense
generally decreased with grade, with fi rst gradersmost often accepting themselves, and third gradersmost often feeling self-realization. The study also
demonstrated that boys accepted the current self
in their own way, but girls did not, while boys felt
themselves as not yet being realized, but girls saw
themselves generally on their way to self-realization,with third-grade girls showing a significantly stronger
tendency toward self-realization.
Furthermore, correlations between the "level ofsatisfaction with high-school life" and the "sense of
self-esteem" scales suggest that students who are
more open-minded, feel a greater sense of pleasure,and more actively accept themselves feel a greater
sense of having friends, and are more satisfied with
their school lives, whereas those more introverted andmore anxious about the opinions of others feel lessof a sense of having friends, less fulfillment in school
activities, and are not so satisfied with their school
lives.
Thus, it was clarifi ed that high-school students’sense of self-esteem and satisfaction with school life
were closely correlated. The contents and magnitudeof the psychological impact of someone’s evaluation
seem to vary depending on the general sense of
self-esteem of the affected person. Those with alower sense of self-esteem are more likely to become
hesitant about communicating with others and put
up a barrier around them, which makes them unable
to open up to others. It is not uncommon for them
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A Survey on The Current Status of High-School Students’ Sense of Self-Esteem

to feel a much stronger sense of inferiority hidden
behind their self-esteem issues (Maekawa, 2005), andpossibly lose friends as a result. They might evenmaladapt to others. Today, it is said that friendships
among young people tend to be superficial, and seemto be maintained with a focus on "relief" (Mizuno,
2004). A study on the relationship between juvenile
delinquency and depression revealed the strong
involvement of the closeness of friendship (Obokata,
et al., 2005). Boden (2007) also reported that there
are strong relationships between self-esteem inadolescents and future violence and hostility.
A persecutory delusion-based notion is positively
co r r e l a t e d w i t h a f e a r o f o t h e r p e o p l e and a
depressive feeling (Kaneko, et al., 2003). Moreover,a study on the relationship between family functions
and the development of pubertal problems (Yoshino,
et al., 2005) demonstrated that antisocial behavior,a manifestation of internal maladaptation to society,could not be accounted for by family functions
alone, but were infl uenced by other factors suchas friendships and the situation in school. In
adolescence, people start to become mentally
independent of their parents, and more infl uenced
by friends in terms of valuing things and choosing
behavior. Since the level of self-esteem regarding
family relations determines the types of friendships
they can have, the importance of introducing an
educational program at an earlier stage to enhanceself-esteem has been emphasized (Ogawa, et al.,2006). Another study demonstrated that a decrease in
self-esteem had a strong impact on eating disorders(Ikeda, et al., 2006). Furthermore, a study on theenvironment and adaptation in adolescents (Okubo,
et al., 2005) reported that addressing problems withadaptation as issues between individuals and theenvironment could expand the possibility for teachersand schools to actively participate in solving suchproblems. In reducing a fear of other people, on
the other hand, the importance of establishing closefriendships, appropriate adjustment of self-love,
and autonomous stabilization of emotion has also
been pointed out (Shimizu, et al., 2005). Given thesignifi cant impacts of grade/gender differences onhigh-school students’ levels of satisfaction with theiroverall school lives, adolescents may need friendsof the same age with whom they can talk about
anything, not only because of their rapid physical andmental changes associated with the development of
secondary sexual characteristics, but also because of
School Health Vol.5, 1-8, 2009http://www.shobix.co.jp/sh/hpe/main.htm

their worries and fears specific to this period of life.
In modern society, or the ‘mental era,’ mental
health management is essential in treating people
showing a depressive tendency while more frequently
thinking negatively. A program to reduce/preventa depressive feeling in university students with adepressive tendency (Shiraishi, et al., 2005) as wellas cognitive-behavioral treatment (Clarke, et al.,1999) and peer support activities (Okada, 2005,
2006) have been developed. Brent, et al., (1997) alsomentioned that cognitive behavior therapy, as werefer to it, was effective, and resulted in a more rapid
and complete treatment response.
Classroom activities to prevent a decrease in
self-efficacy and self-esteem have also been designed
for elementary-school children (Kawai, et al., 2006).
A study that confirmed a causal relationship between
the concept of the psychosocial environment andsubjective symptoms has demonstrated that the
improvement of this environment in the school isan effective strategy for promoting children’s health(Takakura, et al., 2006).
It is important for high-school students to develop
a personality integrated with empathy and sociality,
both of which are nurtured through interactions withothers, to enhance their sense of self-esteem and feelsatisfied with their school lives. Therefore, effective
psychological interventions such as peer support
are necessary to nurture empathy and sociality,and enhance a sense of self-esteem in high-school
students.
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Name:
Michiyo Okada
Affiliation:
Department of Hygiene/Public HealthFaculty of Medicine University of Kagawa

Address:
1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793 Japan
Brief Biographical History:
1989- Senior High School Teacher, a member of Kagawa
Prefectural Board of Education
2002-2004 Master’s Program, Graduate School of Education,
University of Kagawa
2006 - Doctoral Prog ram, G raduate School of Medicine,
University of Kagawa
2007- Lecturer, Faculty of Literature, Shikoku Gakuin University
Main Works:• Investigation on persons with whom high school students
consult about their problems. Journal of Shikoku Public
Health Society. Vol.53, 79-86. (2008)• Investigation on the rate and state of self-reported depressive
sysmptoms in high school samples of Japanese adolescentes:
Using the Birleson Depression Self-Rating Scale for Children( DSRS - C). Japa nese Jou r nal of Ch ild a nd Adolescent
Psychiatry. Vol.50, 57-68. (2009)
Membership in Learned Societies:• Japanese Association of School Health• Japanese Society for Hygiene• Japanese Society of Public Health• Association of Japanese Clinical Psychology• Japanese Society for Child and Adolescent Psychiatry

School Health Vol.5, 1-8, 2009http://www.shobix.co.jp/sh/hp/main.htm